A project of the Galen Institute

Issue: "Medicaid"

Gruber Model Errs in Colorado as Vermont Prepares to Rely on Data

Vermont Watchdog
Tue, 2014-12-16
By Bruce Parker | Vermont Watchdog Jonathan Gruber’s health care forecasting is failing in Colorado as Vermont’s Gov. Peter Shumlin prepares to use the economist’s math for single-payer health care. As Vermonters anxiously await a Gruber-modeled financing plan for Green Mountain Care, modeling done for Colorado’s health exchange by Jonathan Gruber Associates has proven wildly erroneous. In 2011, following Colorado’s decision to set up a state health exchange for Obamacare, the state hired Gruber to forecast enrollment trends from which the state and federal government could estimate costs. According to a presentation delivered to the Colorado Health Benefit Exchange Board on Sept.

If the Supreme Court Breaks Obamacare, Will Republicans Fix It?

National Journal
Mon, 2014-12-15
By Sam Baker and Sophie Novack: Republicans want the Supreme Court to blow a major hole in Obamacare next year, but they are still debating whether they would help repair it—and what they should ask for in return. There's a very real chance the high court will invalidate Obamacare's insurance subsidies in most of the country, which would be devastating for the health care law. It would become almost entirely unworkable in most states, and the cost of coverage would skyrocket. That loss for the Affordable Care Act might seem like a clear-cut political win for the GOP, but the reality would be far messier. Such a ruling would weaken the law's individual mandate and make coverage unaffordable for millions of people.

A Post-ObamaCare Strategy

The Wall Street Journal
Mon, 2014-12-15
With the Supreme Court due to rule on a major ObamaCare legal challenge by next summer, thoughts in Washington are turning to the practical and political response. If the Court does strike down insurance subsidies, the question for Republicans running Congress is whether they will try to fix the problems Democrats created, or merely allow ObamaCare’s damage to grow. The time to define a strategy is soon, as King v. Burwell will be heard in March with a ruling likely in June. As a matter of ordinary statutory construction, the Court should find that when the law limited subsidies to insurance exchanges established by states, that does not include the 36 states where the feds run exchanges. But in that event one result would be an immediate refugee crisis. Of the 5.4 million consumers on federal exchanges, some 87% drew subsidies in 2014, according to a Rand Corporation analysis. Continued... http://www.wsj.com/articles/a-post-obamacare-strategy-1418601071

Eakinomics: Medicaid as “Stimulus”

American Action Forum
Mon, 2014-12-15
Late last night the House approved a $1.1 trillion spending measure that will keep the government funded. The measure passed 219-206, with 162 Republicans and 57 Democrats in favor. The so-called “CRomnibus” now moves onto the Senate where it is expected to pass today. While a House panel was meeting to discuss eliminating the 1970s era ban on crude oil exports, a group of economists from American Council for Capital Formation urged the president to lift the ban. Even according to the government’s own research, “This reduction in oil prices, if they persist for one year, puts approximately $1.3 trillion in the hands of consumers worldwide.” The FCC voted Thursday to increase the E-rate program by $1.5 billion, now totaling $3.9 billion per year. AAF has found that, with this vote, the program has expanded nearly 123 percent since 2008.

Medicaid is broken and expansion won't fix it

Washington Examiner
Mon, 2014-12-15
By Philip Klein | More than one in five Americans, or 68 million people, will receive their health coverage through Medicaid this year — more than any other government health program. But as it adds millions of beneficiaries as a result of President Obama’s healthcare law, there is mounting evidence that Medicaid is broken. Medicaid is administered jointly by the state and federal government, offering health coverage to Americans earning up to about $16,000 in the states participating in Obamacare’s expansion of the program and up to roughly $12,000 in the states that do not. Providing these benefits comes at a great cost to taxpayers. In fiscal 2013 (even before the program expanded) federal and state governments spent nearly $460 billion combined on Medicaid.

ObamaCare’s Threat to Private Practice

The Wall Street Journal
Mon, 2014-12-08
By Scott Gottlieb Dec. 7, 2014 5:12 p.m. ET Here’s a dirty little secret about recent attempts to fix ObamaCare. The “reforms,” approved by Senate and House leaders this summer and set to advance in the next Congress, adopt many of the Medicare payment reforms already in the Affordable Care Act. Both favor the consolidation of previously independent doctors into salaried roles inside larger institutions, usually tied to a central hospital, in effect ending independent medical practices. Republicans must embrace a different vision to this forced reorganization of how medicine is practiced in America if they want to offer an alternative to ObamaCare. The law’s defenders view this consolidation as a necessary step to enable payment provisions that shift the financial risk of delivering medical care onto providers and away from government programs like Medicare.

Exploring the shortcomings and fault lines of the Affordable Care Act

Physicians for a National Health Program
Mon, 2014-12-08
The case for single payer – Medicare for All By Jeoffry B. Gordon, M.D., M.P.H. December 3, 2014 The Patient Protection and Affordable Care Act (ACA) has as its main and overriding purpose the expansion and subsidization of health insurance coverage for many (usually poor and uninsured) Americans who were previously unable to reliably access medical services. Under its auspices, the federal law has provided for health insurance enrollment for 1 million to 3 million additional 19- to 26-year-olds; 6 million new, expanded Medicaid enrollees; and 7.2 million commercial Qualified Health Plan enrollees. Of the latter, about 80 percent qualify for financial subsidy. Taking into account additional factors, e.g. the fact that some of the new enrollees were previously insured, there has been a net gain of about 10 million people who have coverage. Yet even at full expansion, it is estimated that the ACA will not insure another 30 million U.S.

Randy Barnett: How to finally kill Obamacare

USA Today
Fri, 2014-12-05
The Supreme Court is more likely to act if Republicans have an alternative bill ready. Thanks to four justices of the Supreme Court, there is now a clear path to repealing and replacing the Affordable Care Act next year, finally bringing Obamacare to an end. But Republicans won't accomplish this by waiting for the court or just voting to repeal the law one more time. The only way they can succeed is by crafting their own replacement — and they need to start right away. Until the Supreme Court agreed to hear King v. Burwell, which challenges the legality of the IRS rule allowing Obamacare subsidies in states that have not built their own insurance exchanges, the conventional wisdom was that Congress would pass a symbolic bill to repeal Obamacare that everyone knows would be vetoed by the president. Then they'd move on. Obamacare would survive at least until 2017. But the decision to hear King changes everything.

'Healthy Utah' Obamacare Expansion: Worse Than Expected

Forbes
Fri, 2014-12-05
By Jonathan Ingram, Nic Horton and Josh Archambault— Mr. Ingram is Research Director, Mr. Horton Policy Impact Specialist, and Mr. Archambault a Senior Fellow at the Foundation for Government Accountability. After months of secretly negotiating a backroom deal with the Obama administration, Governor Gary Herbert (R-UT) has finally released (some of) the details of his Obamacare expansion plan. We’ve not hesitated to share our disappointment over Herbert’s recent actions to bring Obamacare to Utah (which has always seemed out of character for him), but we’ve also met with the governor and his chief of staff privately to share our concerns about this welfare program. Sadly, Gov. Herbert continues to move forward with an Obamacare expansion plan that is bad for taxpayers and the truly needy. Earlier this morning, Gov. Herbert released more details about his plan to expand Obamacare in Utah.

How to Replace Obamacare

James C. Capretta
National Review
Tue, 2014-12-02
In the 2014 midterm elections, opposition to the Affordable Care Act — i.e., Obamacare — was a clear political winner. That’s obvious from the election results themselves but also from polling that consistently finds that far more of the electorate disapproves of the law than approves of it. It is therefore to be expected that the incoming Congress, fully under the control of the GOP, will vote on a straight repeal bill, probably very early in next session. In the House, such a bill will pass easily. But in the Senate, Democrats will control at least 46 seats in the new Congress, giving them plenty of votes to filibuster most legislation they oppose. Consequently, the most likely scenario is that the repeal legislation will die in the Senate and therefore never get sent to the president for a certain veto. Perhaps that’s just as well, because repeal without a replacement plan is not the best long-term position for ACA opponents anyway.

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